Abstract
Three patients with malfunctioning intracardiac prosthetic valves and traumatic hemolytic anemia with elevation of the alpha-1 and alpha-2 isoenzymes of LDH are presented. Two of these patients had three episodes of chest pain which were diagnosed initially as myocardial infarction because the isoenzyme pattern was thought to be diagnostic. The persistent elevation of total LDH, the normal SGOT and CPK, and documentation of the hemolytic anemia eventually led to the correct diagnosis of LDH and isoenzyme elevation due to hemolysis. While the relationship of traumatic hemolytic anemia and LDH is well known, in the patient with a prosthetic valve and chest pain there may be serious confusion and life-threatening delay.
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